Terrell A Clark
Clinical Child & Adolescent Psychologist
9 Hope Ave
Waltham
, Massachusetts 02453-2741
Terrell A Clark
Clinical Child & Adolescent Psychologist
9 Hope Ave
Waltham
, Massachusetts 02453-2741
(978) 779-6133
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About
Features
Specialties
- Clinical Child & Adolescent Psychologist
Languages spoken
- English
Location
First Address
- Terrell A Clark
- 34 Meadow Rd
- Bolton, MA
- Zip : 01740-1120
- Phone : (978) 779-6133
Second Address
- Terrell A Clark
- 9 Hope Ave
- Waltham, MA
- Zip : 02453-2741
- Fax : (781) 647-8914
- Phone : (781) 216-2200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2856 | MA |
National Provider Identifier
| NPI | 1043283724 |
|---|---|
| Provider Name | Terrell A Clark |
| First Address | Bolton, MA 01740-1120 |
| Second Address | Waltham, MA 02453-2741 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/02/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.